This application requests continued support of the Medical Scientist Training Program at the Medical University of South Carolina. The major goal is to train the next generation of physician-scientists who will choose a career that will conduct research that integrates both the basic and clinical sciences to improve human health and treat diseases. The program was originally founded in 1980 and has steadily grown to its current size of 56 students, with 32% females and 11% underrepresented minorities. Of these 136 alumni, 6 are Professors, 3 holding endowed chairs, 10 associate professors, 21 assistant professors, 6 conduct research in industry, 1 is at the NIH, 2 are at the VA, 8 are clinical faculty (instructor-assistant professor), 27 in private practice, 52 still in training, 1 unknown and 2 deceased. Our 2018 applicant pool is the largest ever with 208 applications. Over the past 5 years (2013-2018) the average number of applicants has been 189/yr, compared to the previous 5-yr average of 152/yr, which is a 24% increase. This increase in our trainee candidate pool reflects a combination of MUSC?s exceptional research environment, our MSTP students? outstanding accomplishments, and the program?s national recruitment efforts, which includes personal contacts and a recruitment letter with brochure sent to students who took the MCAT and received a score of >514 or better. The growth in the quality and quantity of our applicants provides the basis for the requested 10 positions per year. Our program in the medical school is changing to an integrated flex curriculum. In this curriculum, the first two years will be condensed into 18 months, with frequent short vacations. The new preclerkship (FLEX) curriculum will increase flexibility for graduate students to re-enter into medical school. In addition to rigorous basic science research training and medical school, trainees gain experiences in translational research via the Translational Sciences Clinic, a month in the Research Nexus and the Translational Medicine Seminar series. The objectives for the next phase are to: 1) continue the rigorous research training in areas of biomedical research by collaborative and highly accomplished faculty with exceptional records of training and research, 2) offer a training program that challenges students to think independently and critically, 3) conduct the training in a challenging, interactive environment that embraces basic, clinical and translational sciences, 4) utilize individualized development plans to enhance the training experience, 5) continue the rigorous and formal evaluation of the program that uses both quantitative and qualitative data to ensure the most rigorous, effective and efficient training, and 6) institute entrepreneurship training.